| NPI | 1366503021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD436099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 240581) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-01-05 |